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Peter Fraenkel, Ph.D. - Guest
Peter Fraenkel, Ph.D. is an Associate Professor of Psychology at City College of New York; former faculty at the Ackerman Institute for the Family and NYU Medical Center; and is in private practice in New York City. He is the author numerous peer-reviewed articles and chapters, and the books Last Chance Couple Therapy: Bringing Relationships Back from the Brink (2023, Norton); Sync Your Relationship, Save Your Marriage: Four Steps to Getting Back on Track; and is co-author of The Relational Trauma of Incest: A Family-Based Approach to Treatment. Peter lectures and conducts therapist trainings internationally. He received the American Family Therapy Academy’s 2012 award for Innovative Contribution to Family Therapy. He is a former Vice President and past Board Member of AFTA, a Board member of the Minuchin Center for the Family, and a reviewer for several family therapy journals. Peter is also a professional drummer and percussionist, and has performed and recorded worldwide. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Keith Sutton, Psy.D. (00:24):
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. At the Institute for the Advancement of Psychotherapy, we provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement desensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in an evidence-based approach, with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically; our Center for Couples, where all the therapists are using emotionally focused couples therapy; and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma; and our center for ADHD and oppositional and Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D. (01:32):
In the institute, we have our licensed, experienced therapists, and for those in financial need, we have an associated nonprofit, Bay Area Community Counseling, where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about trainings, treatment, and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax deductible.
Keith Sutton, Psy.D. (02:19):
Today I'll be speaking with Dr. Peter Frankel, who is an associate professor of psychology at City College of New York, a former faculty at the Ackerman Institute for the Family and NYU Medical Center. He is also in private practice in New York City and is the author of numerous peer reviewed articles and chapters, and has published several books, including Last Chance Couples Therapy: Bringing Relationships Back From The Brink; Sync Your Relationship, Save Your Marriage: Four Steps to Getting Back On Track; and he is a co-author of The Relational Trauma of Incest: A Family-Based Approach to Treatment. Peter lectures and conducts therapist trainings internationally. He received the American Family Therapy Academy's 2012 award for Innovative Contribution to Family Therapy. He is a former Vice President and current Board Member of AFTA, a Board Member of the Minuchin Center for the Family, and a reviewer for several family therapy journals. Peter is also a professional drummer and percussionist, and has performed and recorded worldwide. Let's listen to the interview.
Keith Sutton, Psy.D. (03:21):
Well, hi Peter. Welcome.
Peter Fraenkel, Ph.D. (03:23):
Thank you. Glad to be here.
Keith Sutton, Psy.D. (03:25):
Yeah, I'm glad you could join us. So, Peter, I know you from, the American Family Therapy Academy, I've heard you speak. I know, I think you're also part of the Ackerman Institute and do work with them. You're coming out to the Association of Family Therapists in Northern California Conference to do a conference on Last Ditch Couples Therapy. So I wanted to learn more about your work, and particularly, you know, the work you do with couples and systemically, but first I always like to kind of find out how people got to doing what they're doing, their kind of evolution of their thinking.
Peter Fraenkel, Ph.D. (04:03):
Sure. Well, this whole focus on last Chance Couple therapy began long ago. I would date it to about 1995 when a rather imposing gentleman and woman came to my office in 1995. And, before entering my office, the fellow, I'm five six, so I'm on the sort side. This guy was probably about six three, and he looked down at me with a mixture of pain and condescension, and looked down at me and said, "We are the couple from hell." And I said, and I quickly said, "Welcome to Purgatory." And in that statement, I started the genesis of my model, which is: How do we create a liminal space? A space that's neither, "We're going to stay together," nor, "We're ready yet to call it quits." And we'll be talking more about that through this podcast. How do we create that space with a couple?
Peter Fraenkel, Ph.D. (05:07):
And what they said was, "We've seen four previous couple therapists, and it hasn't worked out. You are our last chance." And I hit on the notion of calling this Last Chance Couple Therapy. And, you know, I studied with Salvador Minuchin. I was fortunate to be one of his direct students, had also studied with some of his former students before. So I had a very strong basis in structural family therapy. As a junior faculty at Ackerman, I learned a lot about narrative therapy. I met Michael White and was very influenced by narrative work, postmodern work, intergenerational work with Olga Silverstein, and Feminist Family Therapy had a huge impact on me, still does have a huge impact on me, Virginia Golder's work, Marcia Scheinberg. I've been influenced by every single model in our field, and I think they all have value, and that's why I call myself an integrative couples therapists and have written about integrative couples therapy myself.
Peter Fraenkel, Ph.D. (06:16):
How do we bring all the fruits of the cornucopia of models together? Because they all have something valuable to share. But what I wasn't prepared for was, you know, a couple that's so ambivalent about trying. You know, up until then, in my early career, you know, I really got started in the field in 1990. I finished my postgraduate training in 1988 and just launched my practice in 1990. And, you know, so far I've been working with couples that came and committed to changing and ready to work. And you know, with couples like that, they come in, they, they plan to stay together. You know, we hear about the systemic loops that are creating the problem. We have come up with a 50/50 kind of description of what's going on. We assign some homework typically, you know, and pull out our, at that time date book, and now our phones and schedule the next session. But not so, with a Last Chance Couple where one or sometimes both partners are not even sure they want to have a second session.
Peter Fraenkel, Ph.D. (07:31):
You know, they're coming in sometimes at the bequest of their lawyer for one session, and the heat is on us therapists to show that this one session can be potentially helpful and engender some hope and some possibility. So, you know, what's different about, Last Chance Couple Therapy is that the formation of the Therapeutic Alliance is a bit more challenging, because, you know, Bill Dougherty talks about mixed agenda couples, you know, where one partner is prepared to leave and the other wants to stay. And then there's the other kind of Last Chance Couple where both partners are thinking about leaving. So what do you do as a therapist when the motivation is pretty darn low? And how do you engage people to try? One of the key ideas that I've worked with is the notion of experiments and possibility. How do we create a space in which people can try without any, and I add to that phrase "non-binding" experiments and possibility? Here's why that notion of "non-binding" is so important, Keith. It's because the person who's thinking about leaving is often afraid to engage in the nice little homework that we offer: communication skills and statements of affirmation about the partner and so forth. Because they're afraid that if things get better, they'll be stuck.
Peter Fraenkel, Ph.D. (09:08):
Think about it. You know, it's taken them weeks or months to get up the gumption to announce that they're thinking about leaving the relationship. And now here's this shiny therapist who's suggesting some homework to make things better. And they're afraid to try, because if things get better, that's going to decrease their case for leaving. So, we have to make these experiments and possibility non-binding. Meaning, that when we introduce them, we have to say, you know, "We're going to make some experiments. We're gonna see what impact they have on the relationship. And even if things get better, you could still leave."
Keith Sutton, Psy.D. (09:58):
Yeah, I was going to say, it sounds like a paradoxical intervention too, right? Because then it's like, elevating their own authority, their ability, you know, and agency; and accepting where they're at while at the same time, if it goes one way, that's what you were suggesting, or if it goes the other way and they decide to stay, then it works out either way.
Peter Fraenkel, Ph.D. (10:22):
Exactly. Exactly right. That's a good, that's a good catch. And every time I introduce this, in fact, when I come to wherever we're meeting, I don't even know where I'm going, where we're meeting in Northern California, but, I'm going to be showing a tape where, it's the woman who wants to leave, and when I introduced this notion of non-binding experiments and possibility, I'm showing this tape, and she breathes this big sigh of relief, and she says, "I feel so free now." Very interesting. Because she was afraid, especially me as the male therapist, you know, she's worried that I was gonna try to cajole her into staying with her husband, which she was very mixed about.
Keith Sutton, Psy.D. (11:13):
Well, and I think, like you were mentioning too, it takes so much to get up to that point for people to say, "I want this to be done." There's like a process of detachment that happens. So the fear of kind of going back into that space where you're going to get hurt again, I imagine, is really hard. So that's a nice way to, kind of, create some safety around that.
Peter Fraenkel, Ph.D. (11:34):
Exactly. The other thing that we deal with, with Last Chance Couples is low motivation. People come in and say, "I just don't feel motivated to change. I don't feel motivated to try your little experiments and possibilities." So, years ago I developed what I call the Creative Relational Movement Approach to Change, which is a descriptive theory of the change process, and which I introduced to couples in the first session. The first premise of which is: Insight alone does not promote change in behavior. One of the mistakes that many couple therapists make in the work is trying to use, like, family of origin-based interpretations to promote change in interaction. And while I am very keen on doing intergenerational work, it comes later in the work. First people need to see actual interactional change.
Peter Fraenkel, Ph.D. (12:40):
They need to see that there can actually be change before they're willing to go back and talk about their mothers and their fathers and the patterns that they saw in the past. That just the insight alone, you know, they can have full insight, and many people, as you well know, Keith, are in their individual therapies and sometimes for years, and despite that individual therapy, they're not changing. So we need to encourage people to actually change. And so, it's a relief when I introduce this first premise of the Creative Relational Movement Approach, that insight alone does not lead to behavior change. Because that squares with what people have experienced in their therapy experience, what they've seen so far. They've had all this insight work, and they're still not changing. So that's number one.
Keith Sutton, Psy.D. (13:32):
Or even a partner hears their partner and says, "Okay, I'm going to change. I'm going to do this. I understand now." And then nothing happens, and then...
Peter Fraenkel, Ph.D. (13:40):
Right, nothing happens.
Keith Sutton, Psy.D. (13:40):
And then the partner feels let down and they're like, "Ugh, we talked about it a month ago, and they're still doing X, Y, or Z or not doing X, Y, or Z."
Peter Fraenkel, Ph.D. (13:48):
Exactly. Exactly. The second premise is, and this is the one that's probably most controversial in our field, but really if you look at the research, it shouldn't be controversial, is that high levels of consistent motivation are not necessarily for the change process. I assumed, you know, we have this kind of old adage that, you know, more motivated people change, more likely. The research doesn't show that. Actually there isn't any research that shows that high levels of motivation lead to or are more associated with more positive therapeutic outcomes. And that makes sense, if you think about it. Think about yourself or I think about myself: Are you always motivated to go to the gym? No. You know, sometimes you feel like it, sometimes you don't. But if you want to make progress at the gym, you get your ass to the gym. I'm a drummer, as you may know; I have another life as a musician.
Peter Fraenkel, Ph.D. (14:51):
I can tell you, you know, I've been playing for 50 plus years. We do these little exercises called the rudiments: rolls and flams and the famous paradiddle that everybody knows, but doesn't know what it is. And it's the rare drummer that gets up every morning, and says, after years and years, "I can't wait to do my exercises." Instead, you discipline yourself to get up, sit down, and do those things. And once you do them, you feel glad that you did it, and the motivation comes from the action itself. So the point of all this is, the gym story, the drum story, going to work for that matter; I mean, do we wake up every Monday morning and say, "I can't wait to go to work?" No. But once we get into work, the motivation to do what we're doing, builds.
Peter Fraenkel, Ph.D. (15:48):
So the point is: motion; getting things going and doing them is more important than motivation. So the biggest challenge we have as couple therapists is getting people to try, getting people to do, getting people to move. Trying to get them to feel like doing, that's very difficult. And not important, in fact. So I normalize that, and yet another sigh of relief. People say, "Oh, we don't have to feel that motivated? That's good to know." You know? The third step, the third premise in the Creative Relational Movement Approach is that any attempt at changing is necessarily going to feel artificial, even irrational initially. When couples have been fighting like cats and dogs for months or years, and you teach them the Speaker-Listener Technique or some other communication skill, it feels irrational, literally irrational. It doesn't fit with how they've been viewing each other so negatively.
Peter Fraenkel, Ph.D. (17:01):
You're disrupting their negative schemas about each other. And so as much as the skills seem rational to them, they make sense. People, I mean, I'm sure you've taught communication skills and people always say, "Oh, these make a lot of sense." But then they try doing it and they stop, then they don't do it because it didn't feel right in the moment. And that is because it doesn't feel rational in the moment. It doesn't feel rational. It doesn't make sense when you're so fricking pissed-off at each other. So again, we want to normalize the feeling of irrationality and artificiality in the change process. Getting used to a new keyboard on a new computer feels artificial at first. Getting used to any kind of new device -- when I teach a kid, if I'm teaching drums, a new rhythm, you have to teach it slow at first so that they get used to it.
Keith Sutton, Psy.D. (18:05):
Sometimes I use a metaphor of dancing. It's kind of like learning how to dance -- it's kind of awkward and, you know, slow and so on, but if you keep doing it, it eventually becomes graceful.
Peter Fraenkel, Ph.D. (18:16):
Exactly. Exactly right. Right. The fourth premise of this Creative Relational Movement Approach is this notion of experiments and possibility -- non-binding, which I've already described. We're going to give things a go, we're going to try things out and see what happens. We're going to join up together, team up. And one of the other ways I use narrative therapy is to talk about externalizing the problem patterns. We're going to team up against the problem patterns -- problematic communication, negative attributions about one another. We're going to team up against them and try some new things and see what happens, and see what happens. So, you know, engaging people in curiosity. I'm sure that's a term that you use with people. Like, you know, how do we get people curious about themselves, and step back from the problem pattern, so they're not so embedded?" You know, we see this all the time with distressed couples.
Peter Fraenkel, Ph.D. (19:17):
They're so locked in to the nitty gritty. How, how do we help them step back and get curious about what's going on? You know, that's part of the idea of systemic reframes. You know, "Oh, well when you do this, then look at that. You do that. Isn't that interesting?" You know, I mean, I remember, I remember Sal and his inevitable voice saying always, you know, when he would present a reframe systemic perspective to a couple or a family, he'd say, "Isn't that interesting? When you do this, then you do this and then you do this. Very interesting. It's interesting." You know, good at Sal imitation, don't you think?
Keith Sutton, Psy.D. (20:09):
Yeah. It's great. Great. Yeah, I'm trained in emotionally focused couples therapy, so, you know, we're off. Right? We're tracking the cycle and we're, you know, the cycle is what's getting in the way of the closeness and externalizing the cycle, and really looking at that. And as we're reflecting, you know, the cycle back to the clients and so on, that really kind of seeing that circular causality.
Peter Fraenkel, Ph.D. (20:34):
Exactly. Exactly. That's exactly right. Yeah. And that's hard sometimes because the couple just wants to drag you back down into the mud of their conflict and say, "No, no, no, you don't understand. He did this, he said this." And that's where the wear and tear of doing this work comes in. You know, it's like, "No, let's step back. Let's, let's try to take a look at this together." What I find most useful often, I don't know about you, Keith, is to name the vulnerability. And this is something certainly speaking of EFT, Sue Johnson was the master of the notion of naming the vulnerability. And also Mona Fishbane and Michelle Scheinkman , they talk about the vulnerability cycle. You know, when I have a couple that fights like crazy, I'll say, "You know, the two of you are very sensitive people," and things get softer right away. You know, "You're very, very vulnerable and soft and very fragile, you know, in some ways," and they both get quiet. That's often very helpful to break out of the angry, angry, angry conflict that's going on. So much hatred and so much anger, it's painful to watch, you know?
Keith Sutton, Psy.D. (21:56):
Well too, particularly, I think in the EFT thinking, there's what's called kind of "The Burnt-Out Pursuer" that, you know, oftentimes has now become the withdraw-er or withdraw-er cycle. And that, the way I've conceptualized it, you know, that oftentimes when there's anger, there's still investment in the relationship. And there are oftentimes, you know, versus, when I see that detachment in which, in EFT, they talk about this is one of the hardest couples to work with when the cure is now kind of -- and I think about it, it's almost like they put up these walls around to kind of build this castle, and now their partner is asking them to come out and they've protected themselves, and they don't want to make themselves vulnerable to getting hurt again. Because if they even open the door a little bit, they're just going to boom, get hit with that arrow and so it's like walling off or, you know, kind of diminishing.
Keith Sutton, Psy.D. (22:46):
I've also found too that, when I work with couples in this situation, sometimes when I can read it like that, I sometimes will even talk a bit about this, especially with the partner, because they maybe might not be catching on. Sometimes I have partners that are like, "Well, you do this, you do that." And then the person's like, "You know what? I want the divorce." And I had one couple where the partner's, like, "I thought we were talking about, you know, kind of painting the color on the sailboat, not that the boat was on fire and drowning." Like they're completely misreading where their partner was at, and their partner was, was coming in saying, "I'm pretty much done." And the other person is thinking, "We're still at the tit for tat kind of, you know, back and forth." Just was wondering, I don't know if that couple kind of fits into your model?
Peter Fraenkel, Ph.D. (23:35):
Absolutely.
Keith Sutton, Psy.D. (23:36):
Thinking about that or, yeah. When, when somebody's just so done, they're like, pretty much...
Peter Fraenkel, Ph.D. (23:42):
Well, absolutely. I mean, one of the things that happens, I mean, frankly, I think it's often gendered. I don't know if you find this, that, you know, I mean, there's a sad fact that women continue to be more the monitors of the health of a relationship than men. So, men are carrying along, not tracking how unhappy the women in their lives are. And the women are increasingly unhappy, decreasingly happy, decreasingly happy. And they're edging more and more towards these thoughts about dissolving the relationship. Meanwhile, the guy, like you're describing, is still like, on the boat, thinking things are just like, "You know, let's just repaint the sails." And she's thinking like, "The boat is on fire." You know, "The boat's got a hole in it." And when she finally -- this tape that I'll be showing kind of gets at that. Like, he's so shocked that she's feeling like ending things and he feels so betrayed. And she says, "I've been trying to tell you this for, you know, months, years. And you've not been listening to me". So this is one version of the Last Chance Couple is, you know, where one is so clueless, frankly, that there's been a problem, but that's the problem. It's that they've been so out of touch with how unhappy their partner is, and so uncommunicative.
Keith Sutton, Psy.D. (25:14):
Yeah.
Peter Fraenkel, Ph.D. (25:14):
Absolutely.
Keith Sutton, Psy.D. (25:16):
Sometimes that's oftentimes when the withdraw-er is calling up to schedule the appointment, or in these heterosexual kind of, gender-stereotypical couples, the withdraw-er or the husband is like, kind of like scheduling the appointment, and that that's even a first sign of like, okay, wait a second. Is this, you know, is this where the other person is just kind of burnt out and feeling done, and the other person's like scared, "Like, oh no, I'm going to lose my partner. I need to like, step into action here and do something, before it's too late."
Peter Fraenkel, Ph.D. (25:47):
Yeah. Well, you know, that's interesting in terms of also the research on the Therapeutic Alliance, which I'll be talking about at the conference. That, you know, most of the research on the Therapeutic Alliance shows that, you know, that outcomes, positive outcomes have to do with the woman monitoring the degree to which the man is forming a good relationship with the therapist, and the degree to which the woman has a good therapeutic alliance with the man and all this. But what happens when it's the woman who wants to leave? Which is often the case in a Last Chance Couple, not always, but often the case. Suddenly it's the guy who gets called into action, and the research shows that the man is often oblivious to the degree to which the woman has a relationship, a good relationship with the therapist.
Peter Fraenkel, Ph.D. (26:40):
The research doesn't show that, you know, his assessment of her quality relationship with the therapist has much to do with outcomes of the therapy. So, you know, she's doing all the monitoring, and then when she starts to check out, he's suddenly got to assume the load of not just the, you know, relationship with her, but also the relationship with the therapist. You know, so gets very complicated very quickly. Yeah. So I should talk a little bit about what kinds of things I suggest to couples. You know, I'm a big advocate of communication skills. I teach them, I come out of the PREP School -- Prevention and Relationship Enhancement Program of Howard Markman. I trained with Howie and Scott Stanley back in the early nineties. I brought the PREP Program to NYU Medical Center back in the early nineties.
Peter Fraenkel, Ph.D. (27:50):
And I find these skills to be, you know, they're research supported. I teach them. It's a good way of increasing therapeutic credibility. And therapeutic credibility speaking by the way of therapeutic outcomes -- the client's perception of therapeutic credibility -- the credibility of the therapy. I'm the therapist necessarily, but the therapy itself is very important. The degree to which clients find that the therapy is credible. So teaching couples communication skills when they communicate poorly is one way that we can -- early on -- is one way that we can increase the credibility of what we're doing with people. No matter how famous we are. That's less important than what we do with them, and the credibility of what we do with them. So, I teach communication of problem-solving skills early on, sometimes even in the first session. I don't feel like I need to hear, you know, we all at this point do usually a 15-20 minute, sometimes longer consultation over the phone or even over Zoom.
Peter Fraenkel, Ph.D. (29:06):
So you've heard a fair amount about what the problems are already. It's like a little intake, before you have your first session. So, you know, I wanted my first session people to leave feeling like, "This is gonna be useful." So, you know, I will often teach those skills in the first session, and people leave then with a sense of tools, that things -- they're actually going to learn something, that things could actually get better with my help. And some sense of hope, exactly. Credibility and hope. I borrow from John Gottman. It's some very simple stuff, you know, with all the research that John did over decades. It's so interesting to see, you know, in the Love Prescription. What's the Love Prescription? Simple stuff that, you know, your grandmother could have told you if she had a healthy relationship.
Peter Fraenkel, Ph.D. (30:03):
Like say a few nice things about your partner pretty regularly. Like, you know, Statements of Admiration. So I prescribed Statements of Admiration, you know, "You looked nice today," or "I really liked what you had to say at the party about the political situation," Or Statements of appreciation. Another thing that I'm keen on, even with Last Chance Couples, is starting to engage people in small acts of pleasure. Because let's face it Keith, you didn't get together with your partner, you weren't attracted to your partner because you looked across the room at church, or in synagogue, or at a bar, or in a classroom and said, "You know what? This person looks like someone I could solve problems with for the rest of my life." Just is not what initially attracts us to someone. We look at them, we say, "Oh, attractive, you know, interesting, nice conversation."
Peter Fraenkel, Ph.D. (31:08):
You know, we get attracted for all sorts of different reasons, and we gauge the attractiveness of the relationship based on the pleasure that it's affording us. So I don't want to, you know, this is another mistake I think that couple therapists make -- they spent too much time on the front end just focusing on the problems and not enough asking couples to try to do some pleasurable things together. So I developed one of my favorite techniques that I developed, if I may say, is something called the 60 Second Pleasure Point. So shall I tell you what that is? Okay. So Keith, think about all the fun, pleasurable, even sensual, if not sexual activities you could do with a partner in which the activity lasts 60 seconds or less in length. Fun, pleasure, sexual.
Peter Fraenkel, Ph.D. (32:10):
So people say like, "Oh, holding hands, looking into each other's eyes, giving a hug." If they're up for it, Last Chance Couples sometimes aren't, a kiss; looking out the window together; feeding each other a piece of chocolate; if they're physically apart, a nice text; telling a joke, and so forth. So then I suggest that they do six of these 60 Second Pleasure Points -- What are they called? Pleasure Point -- across the day. With a Last Chance Couple, that's probably too much. So I suggest that they do maybe two of these 60 second or less, right, a minute or less, things a day with each of them initiating one of these activities so that it's fair. So, you know, just a little bit of pleasure. A little bit just to get the Bunsen burner of pleasure happening again, and of course, you know, a lot of couple therapy.
Peter Fraenkel, Ph.D. (33:15):
So anyway, that's the Pleasure Piece. A lot of couple therapy is us getting down in the weeds, let's face it. Helping couples negotiate this, that, and the other thing. You know, I mean, we can't avoid that. It's not all highfalutin systemic interpretations. It's like how to deal with childcare, you know, solving financial issues, you know, all sorts of nitty gritty sorts of issues and finding compromise. So much of couple life is about compromise.
Keith Sutton, Psy.D. (33:51):
And I like that piece you're talking about with those Pleasure Points, was it?
Peter Fraenkel, Ph.D. (33:56):
Yes. 60 Second Pleasure Point.
Keith Sutton, Psy.D. (33:57):
60 Second Pleasure Points. Because then, right, it's kind of shifting the attention towards those moments and, you know, trying to be aware of when you can insert those or, you know, noticing from the other person or so on. So at least kind of bringing that intention or awareness into the -- which is helping to shift the systemic cycle, you know, and kind of create some flexibility in it.
Peter Fraenkel, Ph.D. (34:21):
Exactly. Yeah, exactly.
Peter Fraenkel, Ph.D. (34:24):
Very cool. So there's the kind of premises that you start with -- there's the communication skills, there's a 60 Second Pleasure Point, and then -- can you say a little bit more about the work, and especially kind of these couples that are maybe, that this Last Chance, or again, they're coming in because they're, you know, on the brink of ending.
Peter Fraenkel, Ph.D. (34:50):
Well, look, I mean, you know, once things are launched, in terms of behavior change; once they start to see that they can communicate differently; once they start to make some affirmative statements about each other, you know, statements of appreciation and affirmation and admiration; once they start to experience each other a little bit differently, some Pleasure Points; then, you know, and that all can happen within a few sessions, if the couple is really willing. Sometimes it takes longer. Sometimes you're stuck with very difficult entrenched conflict and you've just got to ride it out and provide a holding environment for people as they threaten each other to leave and fight about. I mean, I've had couples that carry on with threats and so forth, and I'm basically just providing a holding space for this, and trying to affirm the possibility of having a next session.
Peter Fraenkel, Ph.D. (35:55):
It's not always so smooth. But, you know, then, some of the family of origin and certainly culture of origin also comes in. You know, exploring people's cultural premises around communication, I mean, that's always interesting too, when you're teaching communication skills and someone says, "In my culture growing up, you know, men and women never communicated this way. You know, and this is very different for me. I like it, but it's very different. I never saw this." Or, "I didn't see this in my family growing up. My parents fought all the time." Or, "They never. I never saw them communicate. I never saw them talk about anything." So, you know and, you know, certainly exploring trigger points. The other thing is, I just got a referral for a couple where there's been infidelity. So I work a lot with infidelity, and I have a whole approach. I have one of my chapters, chapter six in my book, which I should mention -- Last Chance Couple Therapy: Bringing Relationships Back from the Brink. Don't forget to buy! Buy! Buy!
Keith Sutton, Psy.D. (37:10):
Definitely. We'll link it in the show notes, in the bio too.
Peter Fraenkel, Ph.D. (37:14):
Yeah, so chapter six is all about my particular approach to infidelity, which borrows from, you know, the work of Michelle Scheinkman, and Esther Perel, of course, my dear friend Esther, and Janis Abrahms Spring, and others. But adds my own tweak to it. Maybe I should talk a little bit about that work.
Keith Sutton, Psy.D. (37:42):
Yeah, that'd be great. Yeah. Because that oftentimes is a piece that's bringing someone in at their ending or deciding to end...
Peter Fraenkel, Ph.D. (37:49):
Very much. So that's one of the four -- you know, there's five types of Last Chance Couples that -- let me talk about that first. The High Conflict, you know, back and forth, back and forth, High Conflict Couple. Second, scenario -- and these are not types of Last Chance Couples, they're scenarios because sometimes a couple borrows or inhabits more than one of these scenarios, right? So it's not five different types, but five scenarios, or situations. So the second one is Value Violations, and that includes affairs or infidelity, violence -- verbal, emotional abuse, physical violence -- I occasionally work with that, or alcohol or drug overuse or abuse.
Peter Fraenkel, Ph.D. (38:46):
The third category is Temporal Difficulties -- time issues, what I call "projected life chronology issues" -- where partners have different ideas about when to arrive at particular goals: when to have a child; when to retire; when to move from the city to the suburb -- and they're at an impasse because of that. The fourth category is, kind of what you were alluding to before with the burnt-out withdraw-er, or burnt-out pursuer, whichever it was -- where there's burnt-outness on both sides, where the low-pleasure, low-passion couple, which I find to be the hardest couples to work with. Where there's just very little energy. And the fifth category, it's not even in the book, it occurred to me after I published my book, which is where one partner's in individual therapy, and they're so deep into exploring their own individuation, that they think that the only way to fully become themselves is to leave the marriage.
Peter Fraenkel, Ph.D. (40:13):
So those are five scenarios. And back to affairs, the first step is of course the telling of the story. Like, you know, how was it discovered? Often these days it's on the phone, or you know, because of various charges found on credit cards, you know, and there needs to be a hundred percent responsibility taken by the affair-ing partner. I talk about the affair-ing partner and the affaired-on partner. I don't use the term cheating. So the affair-ing partner needs to take a hundred percent responsibility, even if they say, "Well, the reason I had the affair is because I wasn't getting enough sex." We say, "Well, we're going to explore explanations for the affair, but that does not equal excuses.
Keith Sutton, Psy.D. (41:12):
Yeah. Might have been what led to the unhappiness, but not necessarily, right, the action that crossed the line in their dynamic.
Peter Fraenkel, Ph.D. (41:19):
Exactly. It doesn't validate or excuse the behavior. It may have led, prompted you to do it, but there would've been other ways to handle that unhappiness -- talk about it, even leave the marriage if needed, but not have the affair. So there's telling the story, there's the partner fessing up and, you know, taking a hundred percent responsibility for doing the affair. I use an apology ritual, which sounds kind of hokey, but I find is very powerful, where the affair-ing partner apologizes on a daily basis to the affaired-upon partner for the affair, and -- what's a little different -- not just the affair, but for the impact of the affair.
Peter Fraenkel, Ph.D. (42:18):
So, they're going to say something to the effect of, "Doris, Sam" -- could be a woman had the affair, -- " I want to again, apologize for having had the affair and also for the effects that it's likely to have on you for today." So they make the apology in the morning. Very important to do it in the morning, because affairs are traumatic. They truly are. You know, these days everybody's traumatized. You know, like you're traumatized if you don't get your oat milk at Starbucks. But this is really a trauma, with intrusions, and nightmares, and flashbacks, and association, ruminations and so forth. So, the affaired-on partner is traumatized and the source of the trauma is right there. It's the partner. So the affair-ing partner needs to apologize for the potential feelings, traumatic feelings, intrusions, flashbacks that the affaired-on partner's going to have during the day. And so they apologize. They say, "I want to apologize for the affair and for the effect that it might have on you today. And I want to again, assert that I will not do anything like this again and hurt you in this way." And interestingly, as hokey as this sounds, even very sophisticated couples, the affaired-on partner reports back to me if the affair-ing partner forgets to do it. So in other words, it's really meaningful.
Keith Sutton, Psy.D. (44:01):
Yeah. Well, it makes me think of, you know -- sometimes I think about when a couple is connected -- that they feel like their partner is kind of holding them in their heart, that they're thinking about what they need, what they want, what's going on for them. And so it's like a daily declaration of I know what you're going to be--might experience today, and I'm holding you in my heart and thinking of you and the effect on you." I think...
Peter Fraenkel, Ph.D. (44:27):
Exactly, Keith. Exactly.
Keith Sutton, Psy.D. (44:29):
I think there's another piece too that you, you know, many -- just like, if there's a loss, somebody, you know, loses somebody to death or so on -- oftentimes people are like, "Oh, I don't want to say anything because I'm going to make them upset," or so on. Or same kind of thing with the affair, "I don't want to bring it up because it's going to make a conflict go on." But oftentimes the person that has experienced a loss, whether it be a loss of a loved one, or loss of the safety of the relationship, they're thinking about it all the time.
Peter Fraenkel, Ph.D. (44:55):
Exactly.
Keith Sutton, Psy.D. (44:56):
And they're kind of surreally going through the world. So, speaking to it is, you know, basically the person's not alone.
Peter Fraenkel, Ph.D. (45:04):
Exactly. You've nailed it right on the head. Exactly right, yeah. And, you know, I mean, what typically happens, I'm sure you've seen this, is once the affair gets disclosed or discovered, the affair-ing partner wants to move on. Wants things to go back to normal. But the affair-ing-- affaired-on partner partner is, you know, rocked. Their world is rocked, they're traumatized, and they can't just move on. So, this apology ritual, at least for a few seconds -- it only takes a few seconds a day -- shows the affair-ing-- affaired-on partner, that the affair-ing partner is willing to hold, as you say, hold them in their heart and acknowledge the pain and feel some guilt, -- appropriate guilt and shame. You know, these days people don't want to feel any guilt and shame, but, you know, guilt and shame are there for a reason. You know, they're built in for things like this. I mean, you should feel guilty when you hurt yourself, hurt your partner. I mean, that's normal, and if we didn't have that, we'd all be psychopaths.
Keith Sutton, Psy.D. (46:14):
Yeah, it'd be-- that's connected to empathy. Exactly.
Peter Fraenkel, Ph.D. (46:17):
Exactly. So that's important. Another feature of the approach to working with affairs is the conditions that led to the affair need to be looked at very carefully. Did it happen at work? Did it happen with a colleague? If so, how's that going to be handled? Is the colleague going to be moved to another desk? Are you gonna have to get another job? I mean, what's going to happen in order to safeguard the person from not having another fling with this person? Very important. Here's another thing that's really important: is who to tell. I've seen situations where the affaired-on partner goes and tells everybody and it becomes a disaster. And they certainly have a right and a need to tell someone, but they need to be careful about who they tell. Going and telling your mom and your dad may not be the best choice, may not be the best choice if you want to stay in the marriage. Because then coming back, you know, if the mom and dad then take a very negative view of the affair-ing partner, it may be impossible to carry on. So, maybe a sibling who can keep a secret or a good friend. Someone, they need someone to talk to.
Peter Fraenkel, Ph.D. (47:46):
Exactly, can't keep the secret.
Peter Fraenkel, Ph.D. (47:48):
No, it shouldn't be a secret, but they need to be judicious about who they tell.
Keith Sutton, Psy.D. (47:54):
Yeah. And I find too that when there's an affair, you know, if the couple decides to stay together, it's often then such an opportunity for growth because like, oftentimes all of the cards are on the table -- especially if they've talked about potentially ending the relationship, divorce -- that now it's like, "Okay, this is how I've been feeling these years, and this is how I've been feeling." Because they're not talking about all these things. And sometimes it gets it all out on the table to begin to try and rebuild, not necessarily what was, but something new.
Peter Fraenkel, Ph.D. (48:26):
Yes. Absolutely. It can be -- I think Esther talks about this -- that it can be sort of the alarm bell that wakes up, excuse me, wakes up the couple from their previous kind of trance of unhappiness, you know, and stuck-ness. So it can-- that's the best case scenario, is that, you know, they can overcome it with this kind of work, and get over the trauma. The trauma is the big thing. And it is virulent. I mean, you know, the affaired-on partner really suffers sometimes.
Keith Sutton, Psy.D. (49:00):
Yeah. I'm working with a couple right now where, you know, it's like if she felt like they were in this bubble of safety and then it just got popped. So not only, right the thing that happened, but of just the whole identity of the person and their relationship gets shattered.
Peter Fraenkel, Ph.D. (49:18):
Yeah, that's right. Yeah, that's right. The whole identity of like, who we are. Speaking of, let's, can we change topics for a second.
Keith Sutton, Psy.D. (49:29):
Yeah, of course, definitely.
Peter Fraenkel, Ph.D. (49:29):
One of the other things that I'm very keen on these days -- and I'll talk about it in Northern California -- is how -- kind of the big picture in some ways, with these couples and with any couple really, that I think we couple therapists often ignore when we're busy with our techniques and, you know, with our exploration of family of origin, so forth -- which is how do we help couples adopt relational values?
Keith Sutton, Psy.D. (50:00):
Mm.
Peter Fraenkel, Ph.D. (50:02):
And some people have written about this beautifully -- Mona Fishbane being one, Bill Doherty being another, Carmen Knudson-Martin being another -- and I've written some about it as well. So I do an exercise with couples regularly, which is: I say, "Imagine the sky is filled with stars, which it is, and imagine that each of these stars is a value that you want to have shining down on your relationship, guiding you. What are the values that you would wish to have shining down and guiding your relationship?" And so then the couple brainstorms: kindness, compassion, honesty, patience, love, creativity, curiosity, and so forth. And then I show them the accumulated list of values that I've developed over asking this question for several years now from couples. And I've come up with a pretty saturated, at this point, list.
Peter Fraenkel, Ph.D. (51:21):
And then I send the list to the couple and I encourage them to put on one sheet, or so, usually one sheet, the values that they want to live by on a daily basis. The values they want to have informing their relationship. And then they can put that sheet --print it out, they can decorate it if they want, one couple decorated with waves and a sunset because that was meaningful to them -- stand in front of it and hold hands and read off the values and make that kind of their affirmation for the day. Because, you know, we could talk about techniques and all that stuff, but techniques are really-- you know, when we teach the couples communication skills, what are we really teaching? What are we doing? We're teaching fairness, because each person gets a certain amount of time to speak and, we're teaching patience, we're teaching care, listening, compassion. You know, there are underlying values for all the techniques that we teach, but we often don't name them, as couple therapists. So I'm very keen on this right now. And, I think couples appreciate it.
Keith Sutton, Psy.D. (52:44):
Yeah. And I think, right, with the Markman work too, that there's, you know, that I took away from that, that you know, understanding needs to kind of happen before, you know, problem solving. And I think that view of each person feeling understood and being curious about the other person --to understand them, to really get a sense of where they're at -- to then come together to problem solve or whatever it might be.
Peter Fraenkel, Ph.D. (53:12):
Exactly. That's right. Yeah, you first have to hear-- yeah, I had a couple just yesterday who, boy, super high-conflict last chance couple. And, fine, you know, I taught them the speaker-listener technique and somehow magically -- it feels like magic -- they were able to have a conversation just the day before about finances. And they didn't solve anything, which they're usually so keen on solving things. They reported that they just listened to each other. And it was like celebration, like the fact that they just listened to each other and that they were satisfied with the fact that they just listened to each other was like a remarkable shift for them.
Keith Sutton, Psy.D. (54:02):
To be able to be understood or feel seen.
Peter Fraenkel, Ph.D. (54:05):
Yes. To be seen.
Keith Sutton, Psy.D. (54:06):
Yeah. Well, it sounds like you're doing wonderful work. And I'm going to be at the conference, it's in Sonoma, up in wine country in the Bay Area -- San Francisco Bay Area -- and so it's going to be great. And I always love these conferences, you know, because it's usually a small group and we get a nice, intimate kind of experience with the presenter. And we'll see, I might be bringing up a couple for a live demonstration. So it'd be really great to see you and hear more about the work. It sounds like you're doing wonderful work. And I think this is such a need because I think, you know, many couples therapists struggle with folks that are in this kind of dire situation, you know, kind of on the edge. And so it's great that you have some direction and are really kind of addressing this specific subtype of situation that you see in couples work.
Peter Fraenkel, Ph.D. (54:55):
Thank you, Keith. I appreciate your feedback.
Keith Sutton, Psy.D. (54:57):
Yeah. Thanks for coming today. Take care.
Peter Fraenkel, Ph.D. (55:00):
All right. Bye bye.
Keith Sutton, Psy.D. (55:03):
Thank you for joining us today. If you'd like to receive continuing education credits for the podcast you just listened to, please go to therapyonthecuttingedge.com and click on the link for CE. Our podcast is brought to you by the Institute for the Advancement of Psychotherapy, where we provide trainings for therapists in evidence-based models through live and online workshops, on-demand workshops, consultation groups, and online one-way mirror trainings. To learn more about our trainings and treatment for children, adolescents, families, couples, and individual adults, with our licensed experienced therapists in-person in the Bay Area, or throughout California online, and our employment opportunities, go to sfiap.com. To learn more about our associateships and psych assistantships and low fee treatment through our nonprofit Bay Area Community Counseling and Family Institute of Berkeley, go to sf-bacc.org and familyinstituteofberkeley.com. If you'd like to support therapy for those in financial need and training and evidence-based treatments, you can donate by going to BACC’s website at sfbacc.org. BACC is a 501(c)(3) nonprofit so all donations are tax deductible. Also, we really appreciate your feedback. If you have something you're interested in, something that's on the cutting edge of the field of psychotherapy, and you think therapists out there should know about it, send us an email. We're always looking for advancements in the field of psychotherapy to create lasting change for our clients.
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. At the Institute for the Advancement of Psychotherapy, we provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement desensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in an evidence-based approach, with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically; our Center for Couples, where all the therapists are using emotionally focused couples therapy; and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma; and our center for ADHD and oppositional and Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D. (01:32):
In the institute, we have our licensed, experienced therapists, and for those in financial need, we have an associated nonprofit, Bay Area Community Counseling, where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about trainings, treatment, and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax deductible.
Keith Sutton, Psy.D. (02:19):
Today I'll be speaking with Dr. Peter Frankel, who is an associate professor of psychology at City College of New York, a former faculty at the Ackerman Institute for the Family and NYU Medical Center. He is also in private practice in New York City and is the author of numerous peer reviewed articles and chapters, and has published several books, including Last Chance Couples Therapy: Bringing Relationships Back From The Brink; Sync Your Relationship, Save Your Marriage: Four Steps to Getting Back On Track; and he is a co-author of The Relational Trauma of Incest: A Family-Based Approach to Treatment. Peter lectures and conducts therapist trainings internationally. He received the American Family Therapy Academy's 2012 award for Innovative Contribution to Family Therapy. He is a former Vice President and current Board Member of AFTA, a Board Member of the Minuchin Center for the Family, and a reviewer for several family therapy journals. Peter is also a professional drummer and percussionist, and has performed and recorded worldwide. Let's listen to the interview.
Keith Sutton, Psy.D. (03:21):
Well, hi Peter. Welcome.
Peter Fraenkel, Ph.D. (03:23):
Thank you. Glad to be here.
Keith Sutton, Psy.D. (03:25):
Yeah, I'm glad you could join us. So, Peter, I know you from, the American Family Therapy Academy, I've heard you speak. I know, I think you're also part of the Ackerman Institute and do work with them. You're coming out to the Association of Family Therapists in Northern California Conference to do a conference on Last Ditch Couples Therapy. So I wanted to learn more about your work, and particularly, you know, the work you do with couples and systemically, but first I always like to kind of find out how people got to doing what they're doing, their kind of evolution of their thinking.
Peter Fraenkel, Ph.D. (04:03):
Sure. Well, this whole focus on last Chance Couple therapy began long ago. I would date it to about 1995 when a rather imposing gentleman and woman came to my office in 1995. And, before entering my office, the fellow, I'm five six, so I'm on the sort side. This guy was probably about six three, and he looked down at me with a mixture of pain and condescension, and looked down at me and said, "We are the couple from hell." And I said, and I quickly said, "Welcome to Purgatory." And in that statement, I started the genesis of my model, which is: How do we create a liminal space? A space that's neither, "We're going to stay together," nor, "We're ready yet to call it quits." And we'll be talking more about that through this podcast. How do we create that space with a couple?
Peter Fraenkel, Ph.D. (05:07):
And what they said was, "We've seen four previous couple therapists, and it hasn't worked out. You are our last chance." And I hit on the notion of calling this Last Chance Couple Therapy. And, you know, I studied with Salvador Minuchin. I was fortunate to be one of his direct students, had also studied with some of his former students before. So I had a very strong basis in structural family therapy. As a junior faculty at Ackerman, I learned a lot about narrative therapy. I met Michael White and was very influenced by narrative work, postmodern work, intergenerational work with Olga Silverstein, and Feminist Family Therapy had a huge impact on me, still does have a huge impact on me, Virginia Golder's work, Marcia Scheinberg. I've been influenced by every single model in our field, and I think they all have value, and that's why I call myself an integrative couples therapists and have written about integrative couples therapy myself.
Peter Fraenkel, Ph.D. (06:16):
How do we bring all the fruits of the cornucopia of models together? Because they all have something valuable to share. But what I wasn't prepared for was, you know, a couple that's so ambivalent about trying. You know, up until then, in my early career, you know, I really got started in the field in 1990. I finished my postgraduate training in 1988 and just launched my practice in 1990. And, you know, so far I've been working with couples that came and committed to changing and ready to work. And you know, with couples like that, they come in, they, they plan to stay together. You know, we hear about the systemic loops that are creating the problem. We have come up with a 50/50 kind of description of what's going on. We assign some homework typically, you know, and pull out our, at that time date book, and now our phones and schedule the next session. But not so, with a Last Chance Couple where one or sometimes both partners are not even sure they want to have a second session.
Peter Fraenkel, Ph.D. (07:31):
You know, they're coming in sometimes at the bequest of their lawyer for one session, and the heat is on us therapists to show that this one session can be potentially helpful and engender some hope and some possibility. So, you know, what's different about, Last Chance Couple Therapy is that the formation of the Therapeutic Alliance is a bit more challenging, because, you know, Bill Dougherty talks about mixed agenda couples, you know, where one partner is prepared to leave and the other wants to stay. And then there's the other kind of Last Chance Couple where both partners are thinking about leaving. So what do you do as a therapist when the motivation is pretty darn low? And how do you engage people to try? One of the key ideas that I've worked with is the notion of experiments and possibility. How do we create a space in which people can try without any, and I add to that phrase "non-binding" experiments and possibility? Here's why that notion of "non-binding" is so important, Keith. It's because the person who's thinking about leaving is often afraid to engage in the nice little homework that we offer: communication skills and statements of affirmation about the partner and so forth. Because they're afraid that if things get better, they'll be stuck.
Peter Fraenkel, Ph.D. (09:08):
Think about it. You know, it's taken them weeks or months to get up the gumption to announce that they're thinking about leaving the relationship. And now here's this shiny therapist who's suggesting some homework to make things better. And they're afraid to try, because if things get better, that's going to decrease their case for leaving. So, we have to make these experiments and possibility non-binding. Meaning, that when we introduce them, we have to say, you know, "We're going to make some experiments. We're gonna see what impact they have on the relationship. And even if things get better, you could still leave."
Keith Sutton, Psy.D. (09:58):
Yeah, I was going to say, it sounds like a paradoxical intervention too, right? Because then it's like, elevating their own authority, their ability, you know, and agency; and accepting where they're at while at the same time, if it goes one way, that's what you were suggesting, or if it goes the other way and they decide to stay, then it works out either way.
Peter Fraenkel, Ph.D. (10:22):
Exactly. Exactly right. That's a good, that's a good catch. And every time I introduce this, in fact, when I come to wherever we're meeting, I don't even know where I'm going, where we're meeting in Northern California, but, I'm going to be showing a tape where, it's the woman who wants to leave, and when I introduced this notion of non-binding experiments and possibility, I'm showing this tape, and she breathes this big sigh of relief, and she says, "I feel so free now." Very interesting. Because she was afraid, especially me as the male therapist, you know, she's worried that I was gonna try to cajole her into staying with her husband, which she was very mixed about.
Keith Sutton, Psy.D. (11:13):
Well, and I think, like you were mentioning too, it takes so much to get up to that point for people to say, "I want this to be done." There's like a process of detachment that happens. So the fear of kind of going back into that space where you're going to get hurt again, I imagine, is really hard. So that's a nice way to, kind of, create some safety around that.
Peter Fraenkel, Ph.D. (11:34):
Exactly. The other thing that we deal with, with Last Chance Couples is low motivation. People come in and say, "I just don't feel motivated to change. I don't feel motivated to try your little experiments and possibilities." So, years ago I developed what I call the Creative Relational Movement Approach to Change, which is a descriptive theory of the change process, and which I introduced to couples in the first session. The first premise of which is: Insight alone does not promote change in behavior. One of the mistakes that many couple therapists make in the work is trying to use, like, family of origin-based interpretations to promote change in interaction. And while I am very keen on doing intergenerational work, it comes later in the work. First people need to see actual interactional change.
Peter Fraenkel, Ph.D. (12:40):
They need to see that there can actually be change before they're willing to go back and talk about their mothers and their fathers and the patterns that they saw in the past. That just the insight alone, you know, they can have full insight, and many people, as you well know, Keith, are in their individual therapies and sometimes for years, and despite that individual therapy, they're not changing. So we need to encourage people to actually change. And so, it's a relief when I introduce this first premise of the Creative Relational Movement Approach, that insight alone does not lead to behavior change. Because that squares with what people have experienced in their therapy experience, what they've seen so far. They've had all this insight work, and they're still not changing. So that's number one.
Keith Sutton, Psy.D. (13:32):
Or even a partner hears their partner and says, "Okay, I'm going to change. I'm going to do this. I understand now." And then nothing happens, and then...
Peter Fraenkel, Ph.D. (13:40):
Right, nothing happens.
Keith Sutton, Psy.D. (13:40):
And then the partner feels let down and they're like, "Ugh, we talked about it a month ago, and they're still doing X, Y, or Z or not doing X, Y, or Z."
Peter Fraenkel, Ph.D. (13:48):
Exactly. Exactly. The second premise is, and this is the one that's probably most controversial in our field, but really if you look at the research, it shouldn't be controversial, is that high levels of consistent motivation are not necessarily for the change process. I assumed, you know, we have this kind of old adage that, you know, more motivated people change, more likely. The research doesn't show that. Actually there isn't any research that shows that high levels of motivation lead to or are more associated with more positive therapeutic outcomes. And that makes sense, if you think about it. Think about yourself or I think about myself: Are you always motivated to go to the gym? No. You know, sometimes you feel like it, sometimes you don't. But if you want to make progress at the gym, you get your ass to the gym. I'm a drummer, as you may know; I have another life as a musician.
Peter Fraenkel, Ph.D. (14:51):
I can tell you, you know, I've been playing for 50 plus years. We do these little exercises called the rudiments: rolls and flams and the famous paradiddle that everybody knows, but doesn't know what it is. And it's the rare drummer that gets up every morning, and says, after years and years, "I can't wait to do my exercises." Instead, you discipline yourself to get up, sit down, and do those things. And once you do them, you feel glad that you did it, and the motivation comes from the action itself. So the point of all this is, the gym story, the drum story, going to work for that matter; I mean, do we wake up every Monday morning and say, "I can't wait to go to work?" No. But once we get into work, the motivation to do what we're doing, builds.
Peter Fraenkel, Ph.D. (15:48):
So the point is: motion; getting things going and doing them is more important than motivation. So the biggest challenge we have as couple therapists is getting people to try, getting people to do, getting people to move. Trying to get them to feel like doing, that's very difficult. And not important, in fact. So I normalize that, and yet another sigh of relief. People say, "Oh, we don't have to feel that motivated? That's good to know." You know? The third step, the third premise in the Creative Relational Movement Approach is that any attempt at changing is necessarily going to feel artificial, even irrational initially. When couples have been fighting like cats and dogs for months or years, and you teach them the Speaker-Listener Technique or some other communication skill, it feels irrational, literally irrational. It doesn't fit with how they've been viewing each other so negatively.
Peter Fraenkel, Ph.D. (17:01):
You're disrupting their negative schemas about each other. And so as much as the skills seem rational to them, they make sense. People, I mean, I'm sure you've taught communication skills and people always say, "Oh, these make a lot of sense." But then they try doing it and they stop, then they don't do it because it didn't feel right in the moment. And that is because it doesn't feel rational in the moment. It doesn't feel rational. It doesn't make sense when you're so fricking pissed-off at each other. So again, we want to normalize the feeling of irrationality and artificiality in the change process. Getting used to a new keyboard on a new computer feels artificial at first. Getting used to any kind of new device -- when I teach a kid, if I'm teaching drums, a new rhythm, you have to teach it slow at first so that they get used to it.
Keith Sutton, Psy.D. (18:05):
Sometimes I use a metaphor of dancing. It's kind of like learning how to dance -- it's kind of awkward and, you know, slow and so on, but if you keep doing it, it eventually becomes graceful.
Peter Fraenkel, Ph.D. (18:16):
Exactly. Exactly right. Right. The fourth premise of this Creative Relational Movement Approach is this notion of experiments and possibility -- non-binding, which I've already described. We're going to give things a go, we're going to try things out and see what happens. We're going to join up together, team up. And one of the other ways I use narrative therapy is to talk about externalizing the problem patterns. We're going to team up against the problem patterns -- problematic communication, negative attributions about one another. We're going to team up against them and try some new things and see what happens, and see what happens. So, you know, engaging people in curiosity. I'm sure that's a term that you use with people. Like, you know, how do we get people curious about themselves, and step back from the problem pattern, so they're not so embedded?" You know, we see this all the time with distressed couples.
Peter Fraenkel, Ph.D. (19:17):
They're so locked in to the nitty gritty. How, how do we help them step back and get curious about what's going on? You know, that's part of the idea of systemic reframes. You know, "Oh, well when you do this, then look at that. You do that. Isn't that interesting?" You know, I mean, I remember, I remember Sal and his inevitable voice saying always, you know, when he would present a reframe systemic perspective to a couple or a family, he'd say, "Isn't that interesting? When you do this, then you do this and then you do this. Very interesting. It's interesting." You know, good at Sal imitation, don't you think?
Keith Sutton, Psy.D. (20:09):
Yeah. It's great. Great. Yeah, I'm trained in emotionally focused couples therapy, so, you know, we're off. Right? We're tracking the cycle and we're, you know, the cycle is what's getting in the way of the closeness and externalizing the cycle, and really looking at that. And as we're reflecting, you know, the cycle back to the clients and so on, that really kind of seeing that circular causality.
Peter Fraenkel, Ph.D. (20:34):
Exactly. Exactly. That's exactly right. Yeah. And that's hard sometimes because the couple just wants to drag you back down into the mud of their conflict and say, "No, no, no, you don't understand. He did this, he said this." And that's where the wear and tear of doing this work comes in. You know, it's like, "No, let's step back. Let's, let's try to take a look at this together." What I find most useful often, I don't know about you, Keith, is to name the vulnerability. And this is something certainly speaking of EFT, Sue Johnson was the master of the notion of naming the vulnerability. And also Mona Fishbane and Michelle Scheinkman , they talk about the vulnerability cycle. You know, when I have a couple that fights like crazy, I'll say, "You know, the two of you are very sensitive people," and things get softer right away. You know, "You're very, very vulnerable and soft and very fragile, you know, in some ways," and they both get quiet. That's often very helpful to break out of the angry, angry, angry conflict that's going on. So much hatred and so much anger, it's painful to watch, you know?
Keith Sutton, Psy.D. (21:56):
Well too, particularly, I think in the EFT thinking, there's what's called kind of "The Burnt-Out Pursuer" that, you know, oftentimes has now become the withdraw-er or withdraw-er cycle. And that, the way I've conceptualized it, you know, that oftentimes when there's anger, there's still investment in the relationship. And there are oftentimes, you know, versus, when I see that detachment in which, in EFT, they talk about this is one of the hardest couples to work with when the cure is now kind of -- and I think about it, it's almost like they put up these walls around to kind of build this castle, and now their partner is asking them to come out and they've protected themselves, and they don't want to make themselves vulnerable to getting hurt again. Because if they even open the door a little bit, they're just going to boom, get hit with that arrow and so it's like walling off or, you know, kind of diminishing.
Keith Sutton, Psy.D. (22:46):
I've also found too that, when I work with couples in this situation, sometimes when I can read it like that, I sometimes will even talk a bit about this, especially with the partner, because they maybe might not be catching on. Sometimes I have partners that are like, "Well, you do this, you do that." And then the person's like, "You know what? I want the divorce." And I had one couple where the partner's, like, "I thought we were talking about, you know, kind of painting the color on the sailboat, not that the boat was on fire and drowning." Like they're completely misreading where their partner was at, and their partner was, was coming in saying, "I'm pretty much done." And the other person is thinking, "We're still at the tit for tat kind of, you know, back and forth." Just was wondering, I don't know if that couple kind of fits into your model?
Peter Fraenkel, Ph.D. (23:35):
Absolutely.
Keith Sutton, Psy.D. (23:36):
Thinking about that or, yeah. When, when somebody's just so done, they're like, pretty much...
Peter Fraenkel, Ph.D. (23:42):
Well, absolutely. I mean, one of the things that happens, I mean, frankly, I think it's often gendered. I don't know if you find this, that, you know, I mean, there's a sad fact that women continue to be more the monitors of the health of a relationship than men. So, men are carrying along, not tracking how unhappy the women in their lives are. And the women are increasingly unhappy, decreasingly happy, decreasingly happy. And they're edging more and more towards these thoughts about dissolving the relationship. Meanwhile, the guy, like you're describing, is still like, on the boat, thinking things are just like, "You know, let's just repaint the sails." And she's thinking like, "The boat is on fire." You know, "The boat's got a hole in it." And when she finally -- this tape that I'll be showing kind of gets at that. Like, he's so shocked that she's feeling like ending things and he feels so betrayed. And she says, "I've been trying to tell you this for, you know, months, years. And you've not been listening to me". So this is one version of the Last Chance Couple is, you know, where one is so clueless, frankly, that there's been a problem, but that's the problem. It's that they've been so out of touch with how unhappy their partner is, and so uncommunicative.
Keith Sutton, Psy.D. (25:14):
Yeah.
Peter Fraenkel, Ph.D. (25:14):
Absolutely.
Keith Sutton, Psy.D. (25:16):
Sometimes that's oftentimes when the withdraw-er is calling up to schedule the appointment, or in these heterosexual kind of, gender-stereotypical couples, the withdraw-er or the husband is like, kind of like scheduling the appointment, and that that's even a first sign of like, okay, wait a second. Is this, you know, is this where the other person is just kind of burnt out and feeling done, and the other person's like scared, "Like, oh no, I'm going to lose my partner. I need to like, step into action here and do something, before it's too late."
Peter Fraenkel, Ph.D. (25:47):
Yeah. Well, you know, that's interesting in terms of also the research on the Therapeutic Alliance, which I'll be talking about at the conference. That, you know, most of the research on the Therapeutic Alliance shows that, you know, that outcomes, positive outcomes have to do with the woman monitoring the degree to which the man is forming a good relationship with the therapist, and the degree to which the woman has a good therapeutic alliance with the man and all this. But what happens when it's the woman who wants to leave? Which is often the case in a Last Chance Couple, not always, but often the case. Suddenly it's the guy who gets called into action, and the research shows that the man is often oblivious to the degree to which the woman has a relationship, a good relationship with the therapist.
Peter Fraenkel, Ph.D. (26:40):
The research doesn't show that, you know, his assessment of her quality relationship with the therapist has much to do with outcomes of the therapy. So, you know, she's doing all the monitoring, and then when she starts to check out, he's suddenly got to assume the load of not just the, you know, relationship with her, but also the relationship with the therapist. You know, so gets very complicated very quickly. Yeah. So I should talk a little bit about what kinds of things I suggest to couples. You know, I'm a big advocate of communication skills. I teach them, I come out of the PREP School -- Prevention and Relationship Enhancement Program of Howard Markman. I trained with Howie and Scott Stanley back in the early nineties. I brought the PREP Program to NYU Medical Center back in the early nineties.
Peter Fraenkel, Ph.D. (27:50):
And I find these skills to be, you know, they're research supported. I teach them. It's a good way of increasing therapeutic credibility. And therapeutic credibility speaking by the way of therapeutic outcomes -- the client's perception of therapeutic credibility -- the credibility of the therapy. I'm the therapist necessarily, but the therapy itself is very important. The degree to which clients find that the therapy is credible. So teaching couples communication skills when they communicate poorly is one way that we can -- early on -- is one way that we can increase the credibility of what we're doing with people. No matter how famous we are. That's less important than what we do with them, and the credibility of what we do with them. So, I teach communication of problem-solving skills early on, sometimes even in the first session. I don't feel like I need to hear, you know, we all at this point do usually a 15-20 minute, sometimes longer consultation over the phone or even over Zoom.
Peter Fraenkel, Ph.D. (29:06):
So you've heard a fair amount about what the problems are already. It's like a little intake, before you have your first session. So, you know, I wanted my first session people to leave feeling like, "This is gonna be useful." So, you know, I will often teach those skills in the first session, and people leave then with a sense of tools, that things -- they're actually going to learn something, that things could actually get better with my help. And some sense of hope, exactly. Credibility and hope. I borrow from John Gottman. It's some very simple stuff, you know, with all the research that John did over decades. It's so interesting to see, you know, in the Love Prescription. What's the Love Prescription? Simple stuff that, you know, your grandmother could have told you if she had a healthy relationship.
Peter Fraenkel, Ph.D. (30:03):
Like say a few nice things about your partner pretty regularly. Like, you know, Statements of Admiration. So I prescribed Statements of Admiration, you know, "You looked nice today," or "I really liked what you had to say at the party about the political situation," Or Statements of appreciation. Another thing that I'm keen on, even with Last Chance Couples, is starting to engage people in small acts of pleasure. Because let's face it Keith, you didn't get together with your partner, you weren't attracted to your partner because you looked across the room at church, or in synagogue, or at a bar, or in a classroom and said, "You know what? This person looks like someone I could solve problems with for the rest of my life." Just is not what initially attracts us to someone. We look at them, we say, "Oh, attractive, you know, interesting, nice conversation."
Peter Fraenkel, Ph.D. (31:08):
You know, we get attracted for all sorts of different reasons, and we gauge the attractiveness of the relationship based on the pleasure that it's affording us. So I don't want to, you know, this is another mistake I think that couple therapists make -- they spent too much time on the front end just focusing on the problems and not enough asking couples to try to do some pleasurable things together. So I developed one of my favorite techniques that I developed, if I may say, is something called the 60 Second Pleasure Point. So shall I tell you what that is? Okay. So Keith, think about all the fun, pleasurable, even sensual, if not sexual activities you could do with a partner in which the activity lasts 60 seconds or less in length. Fun, pleasure, sexual.
Peter Fraenkel, Ph.D. (32:10):
So people say like, "Oh, holding hands, looking into each other's eyes, giving a hug." If they're up for it, Last Chance Couples sometimes aren't, a kiss; looking out the window together; feeding each other a piece of chocolate; if they're physically apart, a nice text; telling a joke, and so forth. So then I suggest that they do six of these 60 Second Pleasure Points -- What are they called? Pleasure Point -- across the day. With a Last Chance Couple, that's probably too much. So I suggest that they do maybe two of these 60 second or less, right, a minute or less, things a day with each of them initiating one of these activities so that it's fair. So, you know, just a little bit of pleasure. A little bit just to get the Bunsen burner of pleasure happening again, and of course, you know, a lot of couple therapy.
Peter Fraenkel, Ph.D. (33:15):
So anyway, that's the Pleasure Piece. A lot of couple therapy is us getting down in the weeds, let's face it. Helping couples negotiate this, that, and the other thing. You know, I mean, we can't avoid that. It's not all highfalutin systemic interpretations. It's like how to deal with childcare, you know, solving financial issues, you know, all sorts of nitty gritty sorts of issues and finding compromise. So much of couple life is about compromise.
Keith Sutton, Psy.D. (33:51):
And I like that piece you're talking about with those Pleasure Points, was it?
Peter Fraenkel, Ph.D. (33:56):
Yes. 60 Second Pleasure Point.
Keith Sutton, Psy.D. (33:57):
60 Second Pleasure Points. Because then, right, it's kind of shifting the attention towards those moments and, you know, trying to be aware of when you can insert those or, you know, noticing from the other person or so on. So at least kind of bringing that intention or awareness into the -- which is helping to shift the systemic cycle, you know, and kind of create some flexibility in it.
Peter Fraenkel, Ph.D. (34:21):
Exactly. Yeah, exactly.
Peter Fraenkel, Ph.D. (34:24):
Very cool. So there's the kind of premises that you start with -- there's the communication skills, there's a 60 Second Pleasure Point, and then -- can you say a little bit more about the work, and especially kind of these couples that are maybe, that this Last Chance, or again, they're coming in because they're, you know, on the brink of ending.
Peter Fraenkel, Ph.D. (34:50):
Well, look, I mean, you know, once things are launched, in terms of behavior change; once they start to see that they can communicate differently; once they start to make some affirmative statements about each other, you know, statements of appreciation and affirmation and admiration; once they start to experience each other a little bit differently, some Pleasure Points; then, you know, and that all can happen within a few sessions, if the couple is really willing. Sometimes it takes longer. Sometimes you're stuck with very difficult entrenched conflict and you've just got to ride it out and provide a holding environment for people as they threaten each other to leave and fight about. I mean, I've had couples that carry on with threats and so forth, and I'm basically just providing a holding space for this, and trying to affirm the possibility of having a next session.
Peter Fraenkel, Ph.D. (35:55):
It's not always so smooth. But, you know, then, some of the family of origin and certainly culture of origin also comes in. You know, exploring people's cultural premises around communication, I mean, that's always interesting too, when you're teaching communication skills and someone says, "In my culture growing up, you know, men and women never communicated this way. You know, and this is very different for me. I like it, but it's very different. I never saw this." Or, "I didn't see this in my family growing up. My parents fought all the time." Or, "They never. I never saw them communicate. I never saw them talk about anything." So, you know and, you know, certainly exploring trigger points. The other thing is, I just got a referral for a couple where there's been infidelity. So I work a lot with infidelity, and I have a whole approach. I have one of my chapters, chapter six in my book, which I should mention -- Last Chance Couple Therapy: Bringing Relationships Back from the Brink. Don't forget to buy! Buy! Buy!
Keith Sutton, Psy.D. (37:10):
Definitely. We'll link it in the show notes, in the bio too.
Peter Fraenkel, Ph.D. (37:14):
Yeah, so chapter six is all about my particular approach to infidelity, which borrows from, you know, the work of Michelle Scheinkman, and Esther Perel, of course, my dear friend Esther, and Janis Abrahms Spring, and others. But adds my own tweak to it. Maybe I should talk a little bit about that work.
Keith Sutton, Psy.D. (37:42):
Yeah, that'd be great. Yeah. Because that oftentimes is a piece that's bringing someone in at their ending or deciding to end...
Peter Fraenkel, Ph.D. (37:49):
Very much. So that's one of the four -- you know, there's five types of Last Chance Couples that -- let me talk about that first. The High Conflict, you know, back and forth, back and forth, High Conflict Couple. Second, scenario -- and these are not types of Last Chance Couples, they're scenarios because sometimes a couple borrows or inhabits more than one of these scenarios, right? So it's not five different types, but five scenarios, or situations. So the second one is Value Violations, and that includes affairs or infidelity, violence -- verbal, emotional abuse, physical violence -- I occasionally work with that, or alcohol or drug overuse or abuse.
Peter Fraenkel, Ph.D. (38:46):
The third category is Temporal Difficulties -- time issues, what I call "projected life chronology issues" -- where partners have different ideas about when to arrive at particular goals: when to have a child; when to retire; when to move from the city to the suburb -- and they're at an impasse because of that. The fourth category is, kind of what you were alluding to before with the burnt-out withdraw-er, or burnt-out pursuer, whichever it was -- where there's burnt-outness on both sides, where the low-pleasure, low-passion couple, which I find to be the hardest couples to work with. Where there's just very little energy. And the fifth category, it's not even in the book, it occurred to me after I published my book, which is where one partner's in individual therapy, and they're so deep into exploring their own individuation, that they think that the only way to fully become themselves is to leave the marriage.
Peter Fraenkel, Ph.D. (40:13):
So those are five scenarios. And back to affairs, the first step is of course the telling of the story. Like, you know, how was it discovered? Often these days it's on the phone, or you know, because of various charges found on credit cards, you know, and there needs to be a hundred percent responsibility taken by the affair-ing partner. I talk about the affair-ing partner and the affaired-on partner. I don't use the term cheating. So the affair-ing partner needs to take a hundred percent responsibility, even if they say, "Well, the reason I had the affair is because I wasn't getting enough sex." We say, "Well, we're going to explore explanations for the affair, but that does not equal excuses.
Keith Sutton, Psy.D. (41:12):
Yeah. Might have been what led to the unhappiness, but not necessarily, right, the action that crossed the line in their dynamic.
Peter Fraenkel, Ph.D. (41:19):
Exactly. It doesn't validate or excuse the behavior. It may have led, prompted you to do it, but there would've been other ways to handle that unhappiness -- talk about it, even leave the marriage if needed, but not have the affair. So there's telling the story, there's the partner fessing up and, you know, taking a hundred percent responsibility for doing the affair. I use an apology ritual, which sounds kind of hokey, but I find is very powerful, where the affair-ing partner apologizes on a daily basis to the affaired-upon partner for the affair, and -- what's a little different -- not just the affair, but for the impact of the affair.
Peter Fraenkel, Ph.D. (42:18):
So, they're going to say something to the effect of, "Doris, Sam" -- could be a woman had the affair, -- " I want to again, apologize for having had the affair and also for the effects that it's likely to have on you for today." So they make the apology in the morning. Very important to do it in the morning, because affairs are traumatic. They truly are. You know, these days everybody's traumatized. You know, like you're traumatized if you don't get your oat milk at Starbucks. But this is really a trauma, with intrusions, and nightmares, and flashbacks, and association, ruminations and so forth. So, the affaired-on partner is traumatized and the source of the trauma is right there. It's the partner. So the affair-ing partner needs to apologize for the potential feelings, traumatic feelings, intrusions, flashbacks that the affaired-on partner's going to have during the day. And so they apologize. They say, "I want to apologize for the affair and for the effect that it might have on you today. And I want to again, assert that I will not do anything like this again and hurt you in this way." And interestingly, as hokey as this sounds, even very sophisticated couples, the affaired-on partner reports back to me if the affair-ing partner forgets to do it. So in other words, it's really meaningful.
Keith Sutton, Psy.D. (44:01):
Yeah. Well, it makes me think of, you know -- sometimes I think about when a couple is connected -- that they feel like their partner is kind of holding them in their heart, that they're thinking about what they need, what they want, what's going on for them. And so it's like a daily declaration of I know what you're going to be--might experience today, and I'm holding you in my heart and thinking of you and the effect on you." I think...
Peter Fraenkel, Ph.D. (44:27):
Exactly, Keith. Exactly.
Keith Sutton, Psy.D. (44:29):
I think there's another piece too that you, you know, many -- just like, if there's a loss, somebody, you know, loses somebody to death or so on -- oftentimes people are like, "Oh, I don't want to say anything because I'm going to make them upset," or so on. Or same kind of thing with the affair, "I don't want to bring it up because it's going to make a conflict go on." But oftentimes the person that has experienced a loss, whether it be a loss of a loved one, or loss of the safety of the relationship, they're thinking about it all the time.
Peter Fraenkel, Ph.D. (44:55):
Exactly.
Keith Sutton, Psy.D. (44:56):
And they're kind of surreally going through the world. So, speaking to it is, you know, basically the person's not alone.
Peter Fraenkel, Ph.D. (45:04):
Exactly. You've nailed it right on the head. Exactly right, yeah. And, you know, I mean, what typically happens, I'm sure you've seen this, is once the affair gets disclosed or discovered, the affair-ing partner wants to move on. Wants things to go back to normal. But the affair-ing-- affaired-on partner partner is, you know, rocked. Their world is rocked, they're traumatized, and they can't just move on. So, this apology ritual, at least for a few seconds -- it only takes a few seconds a day -- shows the affair-ing-- affaired-on partner, that the affair-ing partner is willing to hold, as you say, hold them in their heart and acknowledge the pain and feel some guilt, -- appropriate guilt and shame. You know, these days people don't want to feel any guilt and shame, but, you know, guilt and shame are there for a reason. You know, they're built in for things like this. I mean, you should feel guilty when you hurt yourself, hurt your partner. I mean, that's normal, and if we didn't have that, we'd all be psychopaths.
Keith Sutton, Psy.D. (46:14):
Yeah, it'd be-- that's connected to empathy. Exactly.
Peter Fraenkel, Ph.D. (46:17):
Exactly. So that's important. Another feature of the approach to working with affairs is the conditions that led to the affair need to be looked at very carefully. Did it happen at work? Did it happen with a colleague? If so, how's that going to be handled? Is the colleague going to be moved to another desk? Are you gonna have to get another job? I mean, what's going to happen in order to safeguard the person from not having another fling with this person? Very important. Here's another thing that's really important: is who to tell. I've seen situations where the affaired-on partner goes and tells everybody and it becomes a disaster. And they certainly have a right and a need to tell someone, but they need to be careful about who they tell. Going and telling your mom and your dad may not be the best choice, may not be the best choice if you want to stay in the marriage. Because then coming back, you know, if the mom and dad then take a very negative view of the affair-ing partner, it may be impossible to carry on. So, maybe a sibling who can keep a secret or a good friend. Someone, they need someone to talk to.
Peter Fraenkel, Ph.D. (47:46):
Exactly, can't keep the secret.
Peter Fraenkel, Ph.D. (47:48):
No, it shouldn't be a secret, but they need to be judicious about who they tell.
Keith Sutton, Psy.D. (47:54):
Yeah. And I find too that when there's an affair, you know, if the couple decides to stay together, it's often then such an opportunity for growth because like, oftentimes all of the cards are on the table -- especially if they've talked about potentially ending the relationship, divorce -- that now it's like, "Okay, this is how I've been feeling these years, and this is how I've been feeling." Because they're not talking about all these things. And sometimes it gets it all out on the table to begin to try and rebuild, not necessarily what was, but something new.
Peter Fraenkel, Ph.D. (48:26):
Yes. Absolutely. It can be -- I think Esther talks about this -- that it can be sort of the alarm bell that wakes up, excuse me, wakes up the couple from their previous kind of trance of unhappiness, you know, and stuck-ness. So it can-- that's the best case scenario, is that, you know, they can overcome it with this kind of work, and get over the trauma. The trauma is the big thing. And it is virulent. I mean, you know, the affaired-on partner really suffers sometimes.
Keith Sutton, Psy.D. (49:00):
Yeah. I'm working with a couple right now where, you know, it's like if she felt like they were in this bubble of safety and then it just got popped. So not only, right the thing that happened, but of just the whole identity of the person and their relationship gets shattered.
Peter Fraenkel, Ph.D. (49:18):
Yeah, that's right. Yeah, that's right. The whole identity of like, who we are. Speaking of, let's, can we change topics for a second.
Keith Sutton, Psy.D. (49:29):
Yeah, of course, definitely.
Peter Fraenkel, Ph.D. (49:29):
One of the other things that I'm very keen on these days -- and I'll talk about it in Northern California -- is how -- kind of the big picture in some ways, with these couples and with any couple really, that I think we couple therapists often ignore when we're busy with our techniques and, you know, with our exploration of family of origin, so forth -- which is how do we help couples adopt relational values?
Keith Sutton, Psy.D. (50:00):
Mm.
Peter Fraenkel, Ph.D. (50:02):
And some people have written about this beautifully -- Mona Fishbane being one, Bill Doherty being another, Carmen Knudson-Martin being another -- and I've written some about it as well. So I do an exercise with couples regularly, which is: I say, "Imagine the sky is filled with stars, which it is, and imagine that each of these stars is a value that you want to have shining down on your relationship, guiding you. What are the values that you would wish to have shining down and guiding your relationship?" And so then the couple brainstorms: kindness, compassion, honesty, patience, love, creativity, curiosity, and so forth. And then I show them the accumulated list of values that I've developed over asking this question for several years now from couples. And I've come up with a pretty saturated, at this point, list.
Peter Fraenkel, Ph.D. (51:21):
And then I send the list to the couple and I encourage them to put on one sheet, or so, usually one sheet, the values that they want to live by on a daily basis. The values they want to have informing their relationship. And then they can put that sheet --print it out, they can decorate it if they want, one couple decorated with waves and a sunset because that was meaningful to them -- stand in front of it and hold hands and read off the values and make that kind of their affirmation for the day. Because, you know, we could talk about techniques and all that stuff, but techniques are really-- you know, when we teach the couples communication skills, what are we really teaching? What are we doing? We're teaching fairness, because each person gets a certain amount of time to speak and, we're teaching patience, we're teaching care, listening, compassion. You know, there are underlying values for all the techniques that we teach, but we often don't name them, as couple therapists. So I'm very keen on this right now. And, I think couples appreciate it.
Keith Sutton, Psy.D. (52:44):
Yeah. And I think, right, with the Markman work too, that there's, you know, that I took away from that, that you know, understanding needs to kind of happen before, you know, problem solving. And I think that view of each person feeling understood and being curious about the other person --to understand them, to really get a sense of where they're at -- to then come together to problem solve or whatever it might be.
Peter Fraenkel, Ph.D. (53:12):
Exactly. That's right. Yeah, you first have to hear-- yeah, I had a couple just yesterday who, boy, super high-conflict last chance couple. And, fine, you know, I taught them the speaker-listener technique and somehow magically -- it feels like magic -- they were able to have a conversation just the day before about finances. And they didn't solve anything, which they're usually so keen on solving things. They reported that they just listened to each other. And it was like celebration, like the fact that they just listened to each other and that they were satisfied with the fact that they just listened to each other was like a remarkable shift for them.
Keith Sutton, Psy.D. (54:02):
To be able to be understood or feel seen.
Peter Fraenkel, Ph.D. (54:05):
Yes. To be seen.
Keith Sutton, Psy.D. (54:06):
Yeah. Well, it sounds like you're doing wonderful work. And I'm going to be at the conference, it's in Sonoma, up in wine country in the Bay Area -- San Francisco Bay Area -- and so it's going to be great. And I always love these conferences, you know, because it's usually a small group and we get a nice, intimate kind of experience with the presenter. And we'll see, I might be bringing up a couple for a live demonstration. So it'd be really great to see you and hear more about the work. It sounds like you're doing wonderful work. And I think this is such a need because I think, you know, many couples therapists struggle with folks that are in this kind of dire situation, you know, kind of on the edge. And so it's great that you have some direction and are really kind of addressing this specific subtype of situation that you see in couples work.
Peter Fraenkel, Ph.D. (54:55):
Thank you, Keith. I appreciate your feedback.
Keith Sutton, Psy.D. (54:57):
Yeah. Thanks for coming today. Take care.
Peter Fraenkel, Ph.D. (55:00):
All right. Bye bye.
Keith Sutton, Psy.D. (55:03):
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